1. DIETA E PREVENÇÃO
CARDIOVASCULAR !
Pedro Carrera Bastos, 2013!

3. COLESTEROL DIETÉTICO < 300 MG/DIA
Dietary Guidelines for Americans, USDA, 2005

4. ALIMENTO (100 G) COLESTEROL
(MG)
Queijo de Azeitão 88
Nata 33% gordura 97
Costoleta de Porco (gorda) grelhada 111
Peito de vitela estufado 121
Camarão Cozido 198
Mexilhão cozido 360
Fígado de vitela grelhado 387
Ovo cozido 408
Tabela de Composição dos Alimentos. Centro de Segurança Alimentar e Nutrição. Instituto nacional de
Saúde Dr. Ricardo Jorge, 2006

5. Limite o consumo de
gemas de ovo

6. US NATIONAL HEALTH AND NUTRITIONAL SURVEY (1984–1994)
6
Okuyama H, et al. World Rev Nutr Diet. 2007;96:1-17.

7. BMJ 2013;346:e8539 doi: 10.1136/bmj.e8539 (Published 7 January 2013)
BMJ 2013;346:e8539 doi: 10.1136/bmj.e8539 (Published 7 January 2013) Page 1 of 13
Research
RESEARCH
Egg consumption and risk of coronary heart disease
and stroke: dose-response meta-analysis of
prospective cohort studies
OPEN ACCESS
12 12 12
Ying Rong doctoral student , Li Chen research fellow , Tingting Zhu research fellow , Yadong
12 12 12
Song research fellow , Miao Yu research fellow , Zhilei Shan research fellow , Amanda Sands
3 3 12
doctoral student , Frank B Hu professor , Liegang Liu professor
1
Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of
Science and Technology, 430030 Wuhan, People’s Republic of China; 2Ministry of Education Key Lab of Environment and Health, School of Public
Health, Tongji Medical College, People’s Republic of China; 3Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston,
MA, USA
Abstract Conclusions Higher consumption of eggs (up to one egg per day) is
Objective To investigate and quantify the potential dose-response not associated with increased risk of coronary heart disease or stroke.
The increased risk of coronary heart disease among diabetic patients
Fig 3 Forest plot of egg consumption and risk of coronary heart disease
association between egg consumption and risk of coronary heart disease
and stroke. and reduced risk of hemorrhagic stroke associated with higher egg
consumption in subgroup analyses warrant further studies.
Design Dose-response meta-analysis of prospective cohort studies.
RISCO DE DOENÇA CARDÍACA CORONÁRIA
Introduction
Data sources PubMed and Embase prior to June 2012 and references
of relevant original papers and review articles.
Cardiovascular disease is now a public health crisis, affecting
Eligibility criteria for selecting studies Prospective cohort studies
millions of people in both developed and developing countries.
with relative risks and 95% confidence intervals of coronary heart disease
Although the rate of death attributable to the disease has declined
or stroke for three or more categories of egg consumption.
in developed countries in the past several decades, it is still the
Results Eight articles with 17 reports (nine for coronary heart disease, leading cause of death and extorts a heavy social and economic
eight for stroke) were eligible for inclusion in the meta-analysis (3 081 toll globally.1-3 In low and middle income countries, the

8. Fig 4 Dose-response analyses of egg consumption and risk of stroke
BMJ 2013;346:e8539 doi: 10.1136/bmj.e8539 (Published 7 January 2013) Page 1 of 13
Research
RESEARCH
Egg consumption and risk of coronary heart disease
and stroke: dose-response meta-analysis of
prospective cohort studies
OPEN ACCESS
12 12 12
Ying Rong doctoral student , Li Chen research fellow , Tingting Zhu research fellow , Yadong
12 12 12
Song research fellow , Miao Yu research fellow , Zhilei Shan research fellow , Amanda Sands
3 3 12
doctoral student , Frank B Hu professor , Liegang Liu professor
1
Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Tongji Medical College, Huazhong University of
Science and Technology, 430030 Wuhan, People’s Republic of China; 2Ministry of Education Key Lab of Environment and Health, School of Public
Health, Tongji Medical College, People’s Republic of China; 3Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston,
MA, USA
Abstract Conclusions Higher consumption of eggs (up to one egg per day) is
Fig 5 Forest plot of egg consumption and risk of stroke
Objective To investigate and quantify the potential dose-response
association between egg consumption and risk of coronary heart disease
not associated with increased risk of coronary heart disease or stroke.
The increased risk of coronary heart disease among diabetic patients
and stroke. and reduced risk of hemorrhagic stroke associated with higher egg
consumption in subgroup analyses warrant further studies.
Design Dose-response meta-analysis of prospective cohort studies.
RISCO DE AVC
Introduction
Data sources PubMed and Embase prior to June 2012 and references
of relevant original papers and review articles.
Cardiovascular disease is now a public health crisis, affecting
Eligibility criteria for selecting studies Prospective cohort studies
millions of people in both developed and developing countries.
with relative risks and 95% confidence intervals of coronary heart disease
Although the rate of death attributable to the disease has declined
or stroke for three or more categories of egg consumption.
in developed countries in the past several decades, it is still the
Results Eight articles with 17 reports (nine for coronary heart disease, leading cause of death and extorts a heavy social and economic
eight for stroke) were eligible for inclusion in the meta-analysis (3 081 toll globally.1-3 In low and middle income countries, the

9. EFEITOS NO CURTO PRAZO
INCREMENTO DE 100 MG/D DE COLESTEROL DIETÉTICO AUMENTOU:
ü CT: 2.2 mg/dl
ü C- HDL: 0.3 mg/dl
9
Okuyama H, et al. World Rev Nutr Diet. 2007;96:1-17.

10. CHOLESTEROL SYNTHESIS, TRANSPORT, & EXCRETION / 225
ENTEROHEPATIC CIRCULATION
HEPATIC PORTAL VEIN Diet (0.4 g/d)
C
CE
GALL
BLADDER
Synthesis
–
– Bile acids
(total pool, 3–5 g)
BILE DUCT
Unesterified
cholesterol CE
pool
C
ACAT CE Bile
C C acids
HL VLDL
C TG Chylomicron CE
TG ILEUM
,C CE
E
LDL C
(apo B-100, E) TG
LIVER receptor CE 8 –9 9
%
9
LDL C
TG
CE
LRP receptor CE
C TG
CE CE
TG C CE
TP
C Bile acids
TG TG CE AT
A-I (0.6 g/d) (0.4 g/d)
CE
LC
CE IDL
C C HDL Feces
(VLDL remnant)
Chylomicron
remnant
LPL C
LDL
(apo B-100, E)
C receptor
EXTRAHEPATIC C Synthesis
TISSUES
CE
Murray R, et al. Harper’s Illustrated Biochemistry 26th Edition.
McGraw-Hill, 2003
Figure 26–6. Transport of cholesterol between the tissues in humans. (C, unesterified cholesterol; CE, cho-

11. LDL PEQUENAS E DENSAS
ü > Entrada no espaço
subendotelial
ü Menos Vit E
ü + Susceptível à
oxidação
ü Elevado TG/HDL-C é um
bom preditor de sdLDL
Griffin BA. Proc Nutr Soc 1999;58:163-69

12. 24, 25]. Other cholesterol-containing foods, such as dairy fed for 4 weeks with a 1-month washout period in between.
products, also contain high concentrations of saturated fat, The participants were classified as insulin sensitive (n=65),
Curr Atheroscler Rep (2010) 12:377–383
which is a confounder for dietary cholesterol effects. This
DOI 10.1007/s11883-010-0130-7
insulin resistant (n=75), and obese insulin resistant (OIR,
might be the reason why controversial results exist n=58). Insulin-resistant and insulin-sensitive individuals had
regarding the effects of dairy products on CHD risk [26]. significant increases in LDL-C of 7.8% and 3.3%, respec-
Clinical trials conducted in children [27], younger adults tively, after consuming 4 eggs per day, whereas OIR
Revisiting Dietary Cholesterol Recommendations: LDL-C at any intake level.
[24, 25], and the elderly [28, 29] have clearly demonstrated individuals had no changes in
that although dietary cholesterol provided by eggs signifi-
Does the Evidence Support a LimitHDL-C was significantly increased for all groups
In contrast,
of 300 mg/d?
cantly increases LDL-C in one third of the population, those even after the consumption of only 2 eggs per day. These
individuals considered hyper-responders to & a cholesterol
Maria Luz Fernandez Mariana Calle studies suggest that dietary management of OIR individuals
challenge exhibit increases in both LDL-C and HDL-C, with need not include restrictions on eggs.
Table 2 Changes in LDL-C, HDL-C, LDL size, and HDL size as a response to dietary cholesterol provided by eggs in various populations
Published online: 4 August 2010
# Springer Science+Business Media, LLC 2010
Population Duration Additional dietary cholesterol LDL-C HDL-C LDL-C/HDL-C ratio LDL size HDL size
Children (n=54) [27] 4 Abstract The mg/d
wk 518 perceived association between Increase Introduction No change
dietary cho- Increase Increase ND
lesterol (DC) and risk for coronary heart disease (CHD) has
Women (n=51) [25] 4 resulted in recommendations of no more than 300 mg/d for Increase
wk 640 mg/d Increase The AmericanNo change
Heart Association (AHA)Increase
recommends ND
no
Men (n=28) [32••] 12 healthy 640 mg/d the United States. These change Increase 300 Decrease
wk persons in No dietary more than mg/d of dietary cholesterolIncrease healthy
(DC) for Increase
recommendations proposed in the 1960s had little scientific
Men/women (n=42) [34] 12 wk 215 mg/d No change Increaseto prevent change risk for coronary heart disease
persons
No increased Increase Increase
evidence other than the known association between (CHD) [1]. These recommendations are mostly based on
Men/women (n=34) [28] 4 saturated640 and cholesterol and animal studies where Increase
wk fat mg/d Increase No change Increase Increase
the presence of both saturated fat and cholesterol in many
Men/women (n=56) [35•] 12 wk 250 mg/d No normal foods and onDecrease
cholesterol was fed in amounts far exceeding change Increase data derived from animal studies where
ND ND
intakes. In contrast, European countries, Asian countries, supraphysiologic doses of cholesterol, ranging from the
Men/women (n=45) [33•] 12 and Canada do not have an upper limit for DC. change No changeof 1,000 mg to 20,000 mg/d for humans, were
wk 400 mg/d No Further, equivalent No change ND ND
current epidemiologic data have clearly demonstrated that fed in order to produce atherosclerosis [2].
HDL-C high-density lipoprotein increasing concentrations of DC arelipoprotein cholesterol; ND not determined. that many other countries do not
cholesterol; LDL-C low-density not correlated with It is important to note
increased risk for CHD. Clinical studies have shown that have the same guidelines for DC. Canada [3••], Korea [4•],
even if DC may increase plasma low-density lipoprotein New Zealand [5], and India [6], for example, do not set an
(LDL) cholesterol in certain individuals (hyper-responders), upper limit for DC, focusing instead on controlling the
this is always accompanied by increases in high-density intake of saturated fat and trans fat, which are the major
lipoprotein (HDL) cholesterol, so the LDL/HDL cholesterol determinants of blood cholesterol concentrations. Similarly,
ratio is maintained. More importantly, DC reduces circu- the European guidelines on cardiovascular disease preven-
lating levels of small, dense LDL particles, a well-defined tion have the following recommendations regarding healthy
risk factor for CHD. This article presents recent evidence food choices: “consume a wide variety of foods, adjust
from human studies documenting the lack of effect of DC energy intake to maintain a healthy weight, encourage
on CHD risk, suggesting that guidelines for DC should be consumption of fruits and vegetables, replace saturated fat
revisited. with mono or polyunsaturated fatty acids and reduce salt
intake” [7]. In contrast to US policies, Europeans have no
Keywords Dietary cholesterol . LDL cholesterol . dietary guidelines for DC [7]. A summary of the dietary

13. REDUZIR INGESTÃO DE GORDURA
TOTAL DIMINUI RISCO DE DCV

15. lly twelve volunteers composite samples taken from each menu once during the
s unable to complete study for both the stabilization diet and intervention diets.
en complete physical The results for the seven composite samples were averaged
within -10 to +20 per- to find the actual composition of the diets. No alcohol was in-
tropolitan Life Insur-
values from the 1983
TABLE 1
r chronic disease was Composition of HNS*27 Diets, Proximal Analysis
a
on was not an exclu- Low-fat diets High-fat diets
cruited tended to have (% of total calories)
e for men in this age Target Target
nsumption, and evi- Measured value Measured value
sionary. Macronutrient energy
eers were confined to distribution
Protein 15.9 16.0 15.7 16.0
tern Human Nutrition Fat 22.2 20.0 38.7 40.0
or the duration of the Carbohydrate 61.9 64.0 45.7 44.0
onfines of the Nutri- Cholesterol content
sed outings, they had (mean, mg/day) -- 360 -- 360
cept that provided by Fatty acid energy
distribution
rotocol was, of neces- Saturated 6.4 5 10.6 10
was monitored, por- Monounsaturated 9.2 10 15.5 20
required to consume Polyunsaturated 6.6 5 12.6 10
heir meals. (A rubber P/S ratio 1.0 1.0 1.2 1.0
ood was scraped from ap/s, polyunsaturated/saturated; HNS-2 7 diet.
Nelson GJ, Schmidt PC, Kelley DS. Lipids. 1995 Nov;30(11):969-76

16. dicated an increase in the plasma very low density lipopro- factory because the conditions of this experiment were ca
n (VLDL) level and a decrease in both the plasma HDL and fully controlled and the statistical power of the protocol w
DL levels. Thus, the total cholesterol level remained con- excellent.
nt because the increase in plasma VLDL cholesterol com- (ii) The average cholesterol level in the subjects was co
nsated for the reduction in HDL-cholesterol and LDL-cho- siderably below that in the European and American popu
terol. Because of individual variations, the standard devia- tions used to develop the Keys et aL (5) and Hegsted et al.
TABLE 6
High- and Low-Fat Diets, Blood Cholesterol, Triglycerides, and Lipoprotein Values
Total HDL- LDL-
cholesterol Triglycerides cholesterol cholesterol
Period Diet mean + SD mean _+ SD mean • SD mean • SD
Entry A d libitum 176.3 + 33.1 85.8 + 28.4 46.3 _+ 14.0 112.8 • 26.8
Stabilization High-fat 172.5 + 30.3 75.3 • 46.4 44.8 • 11.6 112.6 • 21.9
Intervention Low-fat 173.2 _+27.3 91.5 • 38.0 40.5 • 12.4 114.5 • 21.3
Intervention High-fat 176.9 _+ 32.9 66.4 • 41.7 43.2 + 13.4 119.5 _+24.3
Paired t-test, Pvalues a 0.425 0.002 0.258 0.238
~lhe t-test compares only the values at the end of the high- or low-fat diets with the values obtained at the end of the stabi-
lization period, study day 20. Groups A and B values were taken at study day 70 and day 120, depending on the leg of the
intervention diet for the each group; HDL, high density lipoprotein; LDL, low density lipoprotein.
Lipids, Vol. 30, no. 11 (19
Nelson GJ, Schmidt PC, Kelley DS. Lipids. 1995 Nov;30(11):969-76

17. misnomer. The countries around the Mediterranean basin have differe
differ in the amount of total fat, olive oil, type of meat andamount of total fat, olivemilk vs. cheese;intake;
differ in the wine intake; oil, type of meat and wine frui
the rates of coronary heart disease and cancer, with the lower death ra
the rates of coronary heart disease and cancer, with the lower death rates andof Greece (the diet e
Greece. Extensive studies on the traditional diet longer life be
The Greece. Extensive studies on So Special about the ofGreece (the high intake of fruits, vegetables (particularly wildt
Mediterranean Diets: What Is the traditional diet ofDiet of Greece? before 1960) indicate Greeks consists of a
diet
1 of sourdough bread rather than pasta; more olive oil and olives; less m
The Scientific Evidence
of Greeks consists of a high intake of fruits, vegetables (particularly wild plants), nuts and cer
and moderate amounts of wine, more so than other Mediterranean coun
diet of Crete shows a number of protective substances, such as s
of sourdough bread rather than pasta; more olive oil and olives; less(EFA), high amounts of fiber, antioxid
Artemis P. Simopoulos2 (n-6):(n-3) essential fatty acids milk but more cheese
polyphenols from olive oil), vitamins E and C, some of which have been
and Center for Genetics, Nutrition and Health, Washington, DCthan othercancer, including cancer ofcountries. Analyses of th
The moderate amounts of wine, more so Mediterranean the breast. These findings should serve
intervention trials that will test the effect of specific dietary patterns in t
diet of Crete shows a diet,” implying that all Mediterranean people with cancer. J. diet, is131:as selenium, glutathione
ABSTRACT The term “Mediterranean
number of protective substances, sucha 3065S–3073S, 2001.
have the same
Nutr.
(n-6):(n-3) countries around the Mediterranean basin have different diets, religions andWORDS: Their antioxidants (especially resv
misnomer. The essential fatty acids (EFA), high amounts of fiber, diets
KEY
cultures.
diet of Crete (n-3) fatty acids
c wild plants
c a c c
differ in the amount of total fat, olive oil, type of meat and wine intake; milk vs. cheese; fruits and vegetables; and
polyphenols from olive oil), vitamins E and C, some of which have been shown to be assoc
the rates of coronary heart disease and cancer, with the lower death rates and longer life expectancy occurring in
The health of thedietary pattern the population in general
individual and intake and
cancer, including the traditionalvegetables (particularly wild These indicate that the should serve as aa strong incenti
of Greeks consists of a high intake of fruits, of the breast. plants),is thefindings
Greece. Extensive studies on
cancer diet of Greece (the diet before 1960) and cereals mostly in the form genetics and number of diet” is a m
nuts result of interactions between
intervention trials that will testoil and olives; less of specificofdietarypattern of the an in the prevention but in facb
of sourdough bread rather than pasta; more olive the effect milk but environmentalmore fish; less meat;
more cheese; factors. Nutrition is
major importance (1– patterns
environmental factor of
and moderate amounts of wine, more so than other Mediterranean countries. Analyses the dietary 4). Our genetic profile has not changed
and m
surprising
Downloaded from jn.nutrition.org by on September 27, 2006
withofcancer. a number of protective substances, such as selenium, glutathione, a balanced ratio energy expenditure and phys- and diets.
diet Crete shows J. Nutr. 131: 3065S–3073S, 2001. our food supply and in over the past 10,000 y, whereasofmajor changes have taken
place in
sin have d
(n-6):(n-3) essential fatty acids (EFA), high amounts of fiber, antioxidants (especially resveratrol from wine and
ical activity (5–17). Today industrialized societies are charac-
polyphenols from olive oil), vitamins E and C, some of which have been shown to be associated with lower risk of Muslims d
cancer, including cancer of the breast. These findings should serve as a strong incentivefollowing: 1) an increase in energy intake and
terized by the for the initiation of drinks, wh
KEY WORDS: diet of Crete (n-3) fatty acids wild plants
intervention trials that will test the effect of specific dietary patterns in the prevention and management of patientsan c
c c decrease in energy expenditure; 2)
c increase in saturated fat, antioxidants canc
c eat meat o
with cancer. J. Nutr. 131: 3065S–3073S, 2001. (n-6) fatty acids and trans fatty acids and a decrease in (n-3) on. Althou
fatty acid intake; 3) a decrease in complex carbohydrates and usually con
KEY WORDS: diet of Crete (n-3) fatty acids wild plants antioxidants c cancer c (n-6) fattyin cereal grains and a decrease in
fiber intake; 4) an increase acids (14.0 –18.0
The health of the individual and the population infruit andand calcium intakeand 5) a decreasehealth anti-
general intake; (5–17). Furthermore, the ratio of
intake and in protein, status. Ther
c c c c
vegetable Crete have
oxidant
is the the result of of the individual and the betweengeneral intakeisand a numberisof fattythe term 16.74:1, whereas during evolutionThere is n
is
result of interactions population number of diet” a misnomer. There(n-3) just acidsMediterranean diet
The health
interactions between genetics and a
in genetics and health (n-6) to status. Therefore,
not
diet” is a misnomer.
is “Mediterranean
oneFig. 1).
1930 (19).
as low a de
Nutrition not changed but in fact manyit Mediterranean 1, butwhich not
environmental factors. Nutrition is an
major importance (1– 4). Our profile has
was 2–1:1 (Table
environmental factors.genetic environmental an environmental factor of diets (18), the in isfact many Mediterran
is factor of Recent investigations of dietary patterns and health United Na
was 11.3–1
surprising becausestatus of the countries surrounding the ba-
the countries along the Mediterranean Mediterranean basin
major importancey,(1– 4). Our genetic profile hasdifferentchanged majorandsurprisingthem in both dietary countrie
over the past 10,000 whereas major changes have taken sin have not clearly indicate
religions, economic differences among because the
cultural traditions ;10.6 in 1
place in our food supply and in energy expenditure and phys-
over ical activity (5–17). Today industrialized societies are charac- changes have pork or drink wine and other alcoholic
the past 10,000 y, whereas major Muslims do not eat taken and diets. Diets are influenced by religious habits, that is,
sin have different religions, ec
almost thr
United Sta
placedecrease in energy expenditure; 2) an increase inenergy expenditureWednesdays and Fridays but andwine, and so Diets are influence
in our food supply and in saturated fat, eat meat on
terized by the following: 1) an increase in energy intake and drinks, whereasand phys- populations usually do not
Greek Orthodox
drink diets.
1
Presented as part of the 11th Annual Research Conference on Diet, Nutrition
and Cancer held in Washington, DC, July 16 –17, 2001. This conference was
the traditio
tries Study
ical activity (5–17). Today industrialized on. Although Greece and the
(n-6) fatty acids and trans fatty acids and a decrease in (n-3) societies are charac- Mediterranean countries are
fatty acid intake; 3) a decrease in complex carbohydrates and Muslims do not eat pork or d
sponsored by the American Institute for Cancer Research and was supported by
the California Dried Plum Board, The Campbell Soup Company, General Mills, vascular di
usually considered to be areas of medium-high death rates (United St
terized by thean increase in cereal1) an increase in (14.0 –18.0 per 1000 inhabitants), death rates on the island of
fiber intake; 4) following: grains and a decrease in energy intake and Lipton, Mead Johnson Nutritionals, Roche Vitamins Inc. and Vitasoy USA. Guest
drinks, whereas Greek Orthod
editors for this symposium publication were Ritva R. Butrum and Helen A. goslavia, Ja
fruit and vegetable intake; and 5) a decrease in protein, anti- Norman, American Institute for Cancer Research, Washington, DC.
decrease in energy expenditure; 2)the ratio of 1930 (19). No other area in the Mediterranean basin has had Wednesdays and
oxidant and calcium intake (5–17). Furthermore, an increase
Cretein saturated fat, continuously since before
have been below this level
eat meat on
2
To whom correspondence should be addressed.
E-mail: cgnh@bellatlantic.net
order of 5-
the field w
(n-6) fatty acidsacids is 16.74:1, whereas during evolution aasdecrease inCrete, according to data compiled by the
(n-6) to (n-3) fatty
and1). trans fatty acids and low a death rate as (n-3)
fatty status of intake; 3)ofathe dietary MediterraneanhealthDIETÉTICA:and © beforeusually IIforand
G the patterns and basin United Nationsperin0022-3166/01 $3.00 2001yearbook for 1948. Nutritional Sciences. and th
on. Although Greece
acid the countries surroundingORDURA
it was 2–1:1 (Table 1, Fig.
their demographic It
Recent investigations decrease in complex was 11.3–13.7 1000 inhabitants American Society considered to be area
carbohydrates World War
37% E T
fiber clearly indicate major differences among in cereal grains;10.6 ina decrease Cancer and heart disease in the per 1000 inhabitan
intake; 4) an increase them in both dietary almost three times as(19). indeaths proportionally caused
DA NERGIA OTALas CONSUMIDA and 1946 –1948 many
fruit and vegetable intake; and 5) a decrease in protein,Greece before 1960.Crete have been below this l
United States anti-
(14.0 –18.0
in Crete (19). The diet of Crete represents
the traditional diet of The Seven Coun-
3065S
oxidant and calcium intake (5–17). Furthermore, was theratio establish credible data on cardio-
tries Study the first to of
1
Presented as part of the 11th Annual Research Conference on Diet, Nutrition
and Cancer held in Washington, DC, July 16 –17, 2001. This conference was
sponsored by the American Institute for Cancer Research and was supported by 1930 (19). No other area in th
(n-6) to (n-3) fatty acids is 16.74:1, whereas during evolution in contrasting populations
vascular disease prevalence rates
the California Dried Plum Board, The Campbell Soup Company, General Mills,
goslavia, Japan and Greece), with differences low a death rate as Crete, acc
as found on the
(United States, Finland, The Netherlands, Italy, former Yu-
Lipton, Mead Johnson Nutritionals, Roche Vitamins Inc. and Vitasoy USA. Guest
it was 2–1:1 (Table 1, Fig. 1).
editors for this symposium publication were Ritva R. Butrum and Helen A.
United Nations in their demo
Norman, American Institute for Cancer Research, Washington, DC.
2
To whom correspondence should be addressed. order of 5- to 10-fold in coronary heart disease (20). In 1958,

18. DIMINUIÇÃO DA GORDURA
TOTAL DE 35% PARA 32.3%
Burr ML, Fehily AM, Gilbert JF, et al. Lancet 1989; 2:757-761.

19. dification Trial (CVD) prevention, butand some trials have linked diet needed.
Context Multiple epidemiologic studies
cation Trial disease
diovascular long-term intervention data are
with car-
Linda Objective To test the hypothesis that a dietary intervention, intended to be low in
Context Multiple epidemiologic some trials some trials have linked diet with risk.
Context Multiple epidemiologic studies andstudies andhave linked diet with reduce CVD car-
Hsia, MD; fat and high in vegetables, fruits, and grains to reduce cancer, wouldcar-
.
D;
diovascular disease (CVD) prevention, but long-term intervention data are needed. are needed.
diovascular disease (CVD) prevention, but long-term intervention data
L. ; L. Design, Setting, and Participants Randomized controlled trial of 48 835 post-
arcia
D Objective To test the that a dietary intervention, intended to be low in
Objective To test the hypothesishypothesis that a dietary intervention, intended to be low in
menopausal women aged 50 tograins to reduce cancer, would reduce CVD risk.
79 years, of diverse backgrounds and ethnicities, who
fat and highand high in vegetables, fruits, and grains to reduce cancer, would reduce CVD risk.
s; H. fat in vegetables, fruits, and
Lewis H. participated in the Women’s Health Initiative Dietary Modification Trial. Women were
Croix, PhDDesign,Design, Setting, and Participants 541 [40%]) or of 48 835trial of 48 835 post-
PhD; ; Setting, and Participants Randomized controlled trial
an intervention (19 Randomized controlled
post-
randomly assigned to 50 to 79 years, of diverse backgrounds and ethnicities, whogroup (29 294
comparison
L. menopausal women aged
orman L. [60%]) menopausal women agedStudy79 years, of diverse backgrounds and ethnicities, who
in in the Women’s Health 50 to Dietary Modification Trial. Women 1993 and 1998 in
; , MD; participateda free-living setting.InitiativeenrollmentDietary Modification were Women were
participated in the Women’s Health Initiative
occurred between
Trial.
s 40 US clinical centers;intervention (19 541 in this 541 [40%]) orgroup (29 294 group (29 294
randomly assigned to an mean follow-up [40%]) analysis was 8.1 years.
or comparison
L.
Karen L. [60%]) in a free-living setting.to an intervention (19 between 1993 and 1998 in
randomly assigned
Study enrollment occurred
comparison
MD;
D; , MD; InterventioninIntensive behavior Study enrollment group and individual sessions de-
ysiw
. 40 US clinical centers; mean follow-up in this analysis wasin occurred between 1993 and 1998 in
[60%]) a free-living setting. modification 8.1 years.
inda M. signed to reduce total fat intake tofollow-up calories and increase intakes of vegetables/
PhD;
40 US clinical centers; mean 20% of in this analysis was 8.1 years.
Intervention Intensive behavior modification in group and individual sessions de-
Perri, PhD;fruits toInterventionand grains behavior modification inintakescomparison group received
signed to5 servings/d intake to 20% of calories and increase group of vegetables/ sessions de-
reduce total fat Intensive to at least 6 servings/d. The and individual
D; L.
oss diet-related educationgrains to at intake servings/d. The comparison group received of vegetables/
fruits to 5 servings/d and materials.
signed to reduce total fat least 6 to 20% of calories and increase intakes
bins, G. ; Main Outcome Measures grains to at least 6 servings/d. The comparison group received
fruits to 5 servings/d and
nda MD diet-related education materials.
E. Fatal and nonfatal coronary heart disease (CHD), fatal
diet-related education materials.
RISCO
0%
5%
10%
15%
20%
25%
DAC
Total
DCV
RELATIVO
GloriaG. and nonfatal stroke, and CVD and nonfatal coronary heart disease (CHD), fatal
Linda E. Main Outcome Measures Fatal (composite of CHD and stroke).
PhD;
ns, MD; ;Linda G.nonfatal stroke, and CVD (compositeFatal and nonfatal coronary heart disease (CHD), fatal
z, PhD and Main Outcome Measures of CHD and stroke).
Results By year 6, mean fat intakeintake decreased byenergy intake in the inter- in the inter-
Resultsand nonfatal stroke, and CVD (composite of CHD and stroke). intake
Stevens, PhD; By year 6, mean fat decreased by 8.2% of 8.2% of energy
PH; ; ventionvs the comparison group, with small decreases in saturated (2.9%), monoun-
DrPH
aurizio vention Results By year 6, mean fatwith small decreases in saturated (2.9%), monoun-
vs the comparison group,
intake decreased by 8.2% of energy intake in the inter-
se R. ,
ouise R. DrPH;
tolins saturated (3.3%),the comparison group, withincreases occurred :in-intakes of veg-intakes of veg-
saturated (3.3%), and polyunsaturated (1.5%) (1.5%) fat; increases occurred in
and polyunsaturated fat; small decreases in saturated (2.9%), monoun-
TRANS 22%
D; vention vs
; Annlouiseetables/fruits (1.1(3.3%), and grains grains (0.5 serving/d). Low-density lipoprotein cholesterol
etables/fruits (1.1 servings/d)
R. (0.5 serving/d). Low-density lipoprotein cholesterol
saturated servings/d) polyunsaturated (1.5%) fat; increases occurred in intakes of veg-
and and
y R. MD; levels,diastolic blood pressure, and factor VIIc levels were+11% Low-density lipoprotein cholesterol
enry R.
ord,; levels, diastolic blood pressure, and factor VIIc levels were significantly reduced16%
HORTALIÇAS/FRUTA: +30% CEREAIS: significantly reduced by FIBRA: +
etables/fruits and 4.29%, respectively; levels of high-density lipoprotein cho-
(1.1 servings/d) and grains (0.5 serving/d).
3.55 by 3.55
PhD mg/dL, 0.31 mm Hg,
D; ; Henry mg/dL, levels, mm Hg,blood 4.29%, respectively; levels of high-density lipoprotein 3.55
hD R. 0.31 diastolic and pressure, and factor VIIc levels were significantly reduced by cho-
lesterol, triglycerides, glucose, and insulin did not significantly differ in the intervention
unner, PhDlesterol,mg/dL, 0.31 mm numbers who developed CHD,significantly differ in the intervention
ski, MD; ;vs comparison groups. The Hg, and 4.29%, respectively;stroke, of high-density lipoprotein cho-
triglycerides, glucose, and insulin did not levels and CVD (annual-
,ette; ; vs comparison groups. 1000glucose, and JAMA.developed CHD, stroke, and CVD (annual-
MD MD ized incidence rates) were The (0.63%), et al. insulin didand 1357 (0.86%)differ in the intervention
lesterol, triglycerides, numbers who 2006 Feb 8;295(6):655-66
Howard BV, 434 (0.28%), not significantly in the in-
hlebowski, ized incidence rates) were 1000 (0.63%), 434 (0.28%),CHD, 1357 (0.86%) in the in-
D; MD;
tervention and 1549 (0.65%), 642 (0.27%), and 2088 (0.88%) in the comparison group. CVD (annual-
vs comparison groups. The numbers who developed and stroke, and
ranek, MD; The diet ized no significant effects on incidence of CHD434 (0.28%), and 0.97; 95%
had incidence rates) were 1000 (0.63%), (hazard ratio [HR], 1357 (0.86%) in the in-

20. 50%
45%
RISCO RELATIVO
40%
EM MULHERES
35% QUE TINHAM DCV
30%
25%
RISCO
0%
5%
10%
15%
20%
25%
DAC
Total
DCV
RELATIVO
20%
15%
10%
5%
0%
DAC Total DCV
Howard BV, etet al. JAMA. 2006 Feb 8;295(6):655-66
Howard BV, al. JAMA. 2006 Feb 8;295(6):655-66

21. 80
% Pessoas c/ Sd LDL
60 r = -0.95
P< 0.001
40
20
0
% Gordura 0 10 20 30 40 50
% CHO 75 65 55 45 35
Krauss RM. J Nutr 2001;131:340s-43s

22. ÁCIDOS GORDOS SATURADOS
USDA, AHA: < 10% DO TOTAL CALÓRICO
Dietary Guidelines for Americans, USDA, 2010

24. Δ de TC/HDL-C Δ de LDL-C Δ de HDL-C
Mensink RP, Zock PL, Kester AD, Katan MB. Am J Clin Nutr. 2003 May;77(5):1146-55

25. larger effect of changes in the amount and quality of dieta
and carbohydrates on CAD risk (89), and the possible reaso
this were discussed elsewhere (90, 91).
Effects of fatty acids and carbohydrates on serum lipid
lipoproteins
Our results suggest that isoenergetic replacement of SFA
carbohydrates does not improve the serum total:HDL chole
All natural fats contain both SFAs, which do not change this
and unsaturated fatty acids, which lower it. As a result, ev
replacement of dairy fat and tropical fats with carbohydrate
Mensink RP, Zock PL, Kester AD, Katan MB. Am J Clin Nutr. 2003 May;77(5):1146-55
FIGURE 3. Predicted changes (⌬) in the ratio of serum total t

26. Based on Evolutionary, Historical,
Dietary Fat Quality and Coronary Heart
Global, and Modern ed Theory
Disease Prevention: A Unifi Perspectives
Christopher E.on Evolutionary, Historical,
Based Ramsden, MD
Global, and Modern Perspectives
Keturah R. Faurot, PA, MPH
Pedro ChristopherFaurot, PA, MPH
Carrera-Bastos, MD
Keturah R.
E. Ramsden, BA
Loren Pedro Carrera-Bastos, BA
Cordain, PhD
Loren Cordain, PhD
Michel De De Lorgeril, MD, PhD PhD
Michel
Lorgeril, MD,
Laurence S. Sperling, MD
Laurence S. Sperling, MD
Corresponding author
Corresponding author
Christopher E. Ramsden, MD
Department of Physical Medicine and Rehabilitation, Program on
Christopher E. Ramsden,University of North Carolina–Chapel Hill School
Integrative Medicine, MD
Department Medicine, CB# 7200, Chapel Hill, and Rehabilitation, Program on
of of Physical Medicine NC 27599, USA.
E-mail: cramsden@med.unc.edu
Integrative Current Treatment Options in Cardiovascular Medicine 2009, 11:289–301Hill School
Medicine, University of North Carolina–Chapel
of Medicine, CB# 7200, Chapel Hill, NC 27599, USA.
Current Medicine Group LLC ISSN 1092-8464
Copyright © 2009 by Current Medicine Group LLC
E-mail: cramsden@med.unc.edu
Current Treatmentstatement in Cardiovascular Medicine 2009, 11:289–301
Opinion Options
Current Medicine and growing body of evidence indicates that dietary fatty acids regulate
A large Group LLC ISSN 1092-8464
Copyright © 2009 by Current Medicine in the pathogenesis of coronary heart disease
crucial metabolic processes involved Group LLC
(CHD). Despite this evidence, optimal dietary fatty acid intakes for CHD preven-
tion remain unclear. Significant gaps in the modern nutrition literature and contra-
dictions in its interpretation have precluded broad consensus. These shortcomings
Opinion statement
can be addressed through the incorporation of evolutionary, historical, and global
perspectives. The objective of this review is to propose a unified theory of optimal
A large and growing bodyCHD evidence indicates that dietary fatty acids regulate
dietary fatty acid intake for of prevention that integrates critical insights from
evolutionary, historical, global, and modern perspectives. This broad approach may
crucial metabolic processesmethods to characterize optimal fatty acid intakes. coronary heart disease
be more likely than previous involved in the pathogenesis of
(CHD). Despite this evidence, optimal dietary fatty acid intakes for CHD preven-
tion remain unclear. Significant gaps in the modern nutrition literature and contra-
Introduction
dictions Coronaryinterpretation have precluded broad consensus. Thesewith increasing dura-
in its heart disease (CHD) incidence and mor- resident inhabitants, especially shortcomings
can be addressed through the incorporation tion of residence [5–7].
tality reflect complex interactions between genetic of evolutionary, historical, and global
susceptibilities and environmental factors. Although For instance, CHD is historically far more common in
perspectives. CHD susceptibility genesthis review is to the United States unified theory of men of Japa-
several The objective of have been identified propose a than in Japan [4]. Among optimal
dietary fattyrather lines genetics is the main driver environ- nese ancestry,highestriskCaliforniain[8,9]. These differences
ment
acid intake for CHD prevention Hawaii,integrates is lowest Japan, intermediate in
[1], several
than
of evidence indicate that
of CHD
that and CHD in critical insights from
evolutionary, historical, global,CHD incidence and appear to reflect This broad of traditional Japanese
risk [2]. Globally, age-adjusted and modern perspectives. the replacement approach may
be moremortality vary as previous factors arepopulations cultural traditions with Western acid [8]. Indeed, Japa-
likely than much as 10-fold across sensitive to nese Americans who maintained habits intakes. and
[3,4]. CHD incidence and risk
methods to characterize optimal fatty traditional customs
lifestyle changes. When immigrants from traditionally habits had a CHD risk similar to that of their counterparts
low-risk regions adopt the habits of high-risk popula- residing in Japan, whereas those who adopted Western cul-
tions, their CHD incidence rises to approach that of ture had a three- to fivefold excess in CHD prevalence [8].
Introduction

27. CHINA RURAL: < 5% EUA: 11-12% CRS: 4-18%
KITAVA: 17% MAASAI: 30-35% TOKELAU: 40%

29.
A meta-analysis of prospective epidemiologic
studies showed that there is no significant
evidence for concluding that dietary
saturated fat is associated with an
increased risk of CHD or CVD

30. AUMENTO DO RÁCIO PUFA/SAFA
EM 100%
DIMINUIÇÃO DA GORDURA TOTAL DE
35% PARA 32.3%
Burr ML, Fehily AM, Gilbert JF, et al. Lancet 1989; 2:757-761.

31. Orange Juice on Inflammation, Endoto
C l li in i icca l l C a rree//EEd uucca t t i o n / N u t r i t oo Expression e of cToll-Like Recept
C n a Ca d a andu the nn / P s y c h o s o c aa l R R s s e a r h h
ion/N tritii /Psychosoci i l e ear c
O R I I G I I N A LL
O R G N A
and Suppressor of Cytokine Signaling-
A R TT I I CC L L EE
A R
RUPALI DEOPURKAR, PHD PRIYA MOHANTY, MD vital to the protection fro
Differential Effects of Cream, Glucose, and
Differential Effects of Cream, Glucose, andHUSAM GHANIM, PHD
JAY FRIEDMAN, PHD
PRABHAKAR VISWANATHAN, PHD
AJAY CHAUDHURI, MD
ins and immunological
commensal and patho
Orange Juice on Inflammation, Endotoxin,
Orange Juice on Inflammation, Endotoxin,
SANAA ABUAYSHEH, BSC PARESH DANDONA, MD, PHD bacteria.
CHANG LING SIA, BSC In this context, we w
which macronutrient wa
and the Expression of Toll-Like Receptor-4
and the Expression of Toll-Like Receptor-4 the induction of oxidati
OBJECTIVE — We have recently shown that a high-fat high-carbohydrate (HFHC) meal flammation, on the one h
and Suppressor of Cytokine Signaling-3
and Suppressor of Cytokine Signaling-3
induces an increase in plasma concentrations of endotoxin (lipopolysaccharide [LPS]) and the crease in LPS concent
expression of Toll-like receptor-4 (TLR-4) and suppresser of cytokine signaling-3 (SOCS3) in
mononuclear cells (MNCs) in addition to oxidative stress and cellular inflammation. Saturated
expression of TLR-4 and
fat and carbohydrates, components of the HFHC meal, known to induce oxidative stress and tokine signaling (SOCS)
RUPALI DEOPURKAR, ,PHD
RUPALI DEOPURKAR PHD PPRIYA induce an , MD in LPS, TLR-4, and SOCS3. toto the protection from To elucidate this, we inv
inflammation, alsoMOHANTYMD
RIYA MOHANTY, increase vital the protection from bacterial tox-
vital bacterial tox-
HUSAM GHANIM, ,PHD
HUSAM GHANIM PHD PPRABHAKAR VISWANATHANPHD
RABHAKAR VISWANATHAN, , PHD ins and immunological responses glucose,
fect ofto the the most
ins and immunological responses to the
JJAYFRIEDMAN, ,PHD
AY FRIEDMAN PHD RESEARCH DESIGN AND METHODS — Fasting normal subjects were given 300- hydrate, cream, a sat
AAJAY CHAUDHURIMD
JAY CHAUDHURI, , MD commensal and pathogenic intestinal
commensal and pathogenic intestinal
SANAA ABUAYSHEH, ,BSC
SANAA ABUAYSHEH BSC calorie drinks of either glucose, saturated fat as cream, orange juice, or only water to ingest. Blood orange juice, a carbohy
PPARESH DANDONAMD, PHD
ARESH DANDONA, , MD, PHD bacteria.
CHANG LING SSIA,BSC bacteria. food product, which do
CHANG LING IA, BSC samples were obtained at 0, 1, 3, and 5 h for analysis.
InIn this context, we wanted to analyzestress or in
this context, we wanted to analyze
ther oxidative
which macronutrient was responsible for is a protein
RESULTS — Indexes of inflammation including nuclear factor-␬B (NF-␬B) binding, andwas responsible for
which macronutrient the SOCS3
the induction ofof in MNCs, stress and in-
expression of SOCS3, tumor necrosis factor-␣ (TNF-␣), and interleukin (IL)-1␤ oxidative
the induction oxidative stress and in-
shown to interfere with i
OBJECTIVE — We have recently shown thatsignificantly high-carbohydrate (HFHC) meal TLR-4 expressionon the one LPS signal transduction (2–
OBJECTIVE — We have recently shown thata ahigh-fat after glucose and cream intake, but flammation, and plasma hand, and the in-
increased high-fat high-carbohydrate (HFHC) meal flammation, on the one hand, and the in-
induces an increase in plasma concentrations of endotoxin (lipopolysaccharide intake. The intake of orangein LPS water did not work has shown that SO
concentrations increased only after cream [LPS]) and the
induces an increase in plasma concentrations of endotoxin (lipopolysaccharide [LPS]) and the crease juice LPS concentrations and the
expression of Toll-like receptor-4 (TLR-4) andany change inof cytokineindexes measured. crease in or concentrations and the
induce suppresser of of the signaling-3 (SOCS3) in
expression of Toll-like receptor-4 (TLR-4) and suppresser anycytokine signaling-3 (SOCS3) in expression of TLR-4 and suppresser of cy-
mononuclear cells (MNCs) in addition to oxidative stress and cellular inflammation. Saturated expression of TLR-4 and suppressercirculating mo
mononuclear cells (MNCs) in addition to oxidative stress and cellular inflammation. Saturated tokine signaling (SOCS)-3 on the other. obese hu
in the of cy-
(MNCs) of the
fat and carbohydrates, components of the HFHC meal, known toto induce oxidative stress and tokine signalingand an in- on the other.
fat and carbohydrates, components of CONCLUSIONSknown induce oxidative stress and induce NF-␬B binding (SOCS)-3 increased when compar
the HFHC meal, — Although both glucose and cream
To elucidate this, we investigated the ef-
inflammation, also induce an increase in LPS, the expression of SOCS3, TNF-␣, and IL-1␤ in MNCs, onlyelucidate this, increase normalthe ef-
inflammation, also induce an increase in LPS, inTLR-4, and SOCS3.
crease TLR-4, and SOCS3. To cream caused an we investigated subjects
fectorange juice or watermost important carbo- (6). I
in LPS concentration and TLR-4 expression. Equicaloric amounts of ofof glucose, the did not work carbo-
fect glucose, the most important demonstrated that
hydrate, cream, a a saturated fat, and
hydrate, cream, saturated fat, and
RESEARCH DESIGN AND METHODS — Fasting normal subjects were given 300-are relevant to the pathogenesis of sion in MNCs is inverse
induce a change in any of these indexes. These changes
RESEARCH DESIGN AND METHODS — Fasting normal subjects were given 300- orange juice, a carbohydrate-containing
calorie drinks of either glucose, saturatedatherosclerosisorange juice,resistance. water to ingest. Blood orange juice, a carbohydrate-containing
fat as cream, and insulin or only water to ingest. Blood
calorie drinks of either glucose, saturated fat as cream, orange juice, or only tyrosine phosphorylatio
samples were obtained at 0, 1, 3, and 55 h for analysis.
samples were obtained at 0, 1, 3, and h for analysis. food product, which does not induce and directly rel
product, which does receptor ei-
foodCare 33:991–997, 2010 not induce ei-
Diabetes
ther oxidative stress oror inflammation.
ther oxidative stress inflammation.insulin resistance (home
O
SOCS3 is is a protein that has been
RESULTS — Indexes of inflammation including nuclear factor-␬Bshown thatbinding, and the because the content of LPS sessment of a protein that has been insulin res
ur recent work has (NF-␬B) binding, and the shown to interfere with insulin and leptin
RESULTS — Indexes of inflammation including nuclear factor-␬B (NF-␬B) a great interest SOCS3
expression of SOCS3, tumor necrosis factor-␣ (TNF-␣), and interleukin (IL)-1␤ ininthese meals is not to interfere with insulin and leptin
MNCs, IR]), consistent with
expression of SOCS3, tumor necrosis factor-␣ (TNF-␣), and interleukin (IL)-1␤ in MNCs, shown significantly differ-
high-fat high-cholesterol (HFHC)
increased significantly after glucose and cream intake, but TLR-4 expression and plasma LPS signal transduction (2–5). Our recent of insulin r
increased significantly after glucose and cream intake, butoxidative and inflam- plasma LPS signal transduction (2–5). Our recent
pathogenesis
meal induces TLR-4 expression and ent, and, thus, it would appear that the
concentrations increased only after cream intake. The intake ofof orange juice or water did not work has shown that SOCS3 resistance in human obe
concentrations increased only after cream intake. The intake orange juice oran inflammatory work has shownmay lead
water did not expression
matory stress in addition to inducing nature of the meal that SOCS3 expression
induce any change in any of the indexes measured. inability of leptin to ca

32. (R01-D
Differential Effects of Cream, Gluco the Am
Orange Juice on Inflammation,The da End
and we
and the Expression of Toll-Likepretatio Rec
and Suppressor of Cytokine Signal investig
vestiga
RUPALI DEOPURKAR, PHD PRIYA MOHANTY, MD vitalfor the
to the pro
HUSAM GHANIM, PHD PRABHAKAR VISWANATHAN, PHD ins and immu
JAY FRIEDMAN, PHD AJAY CHAUDHURI, MD commensal p
No a
SANAA ABUAYSHEH, BSC PARESH DANDONA, MD, PHD bacteria. art
this
CHANG LING SIA, BSC In this con
Nata which macron
the induction
OBJECTIVE — We have recently shown that a high-fat high-carbohydrate (HFHC) meal flammation, on
induces an increase in plasma concentrations of endotoxin (lipopolysaccharide [LPS]) and the Referen
crease in LPS
expressionGh
1. of T
expression of Toll-like receptor-4 (TLR-4) and suppresser of cytokine signaling-3 (SOCS3) in
mononuclear cells (MNCs) in addition to oxidative stress and cellular inflammation. Saturated
fat and carbohydrates, components of the HFHC meal, known to induce oxidative stress and tokine signalin
nie
inflammation, also induce an increase in LPS, TLR-4, and SOCS3. To elucidate th
JM
fect of glucose,
RESEARCH DESIGN AND METHODS — Fasting normal subjects were given 300- tox
hydrate, crea
calorie drinks of either glucose, saturated fat as cream, orange juice, or only water to ingest. Blood orange juice,
samples were obtained at 0, 1, 3, and 5 h for analysis. Sumo de of
food product,
Laranja cyt
ther oxidative
RESULTS — Indexes of inflammation including nuclear factor-␬B (NF-␬B) binding, and the SOCS3 is
expression of SOCS3, tumor necrosis factor-␣ (TNF-␣), and interleukin (IL)-1␤ in MNCs,
fol
shown to inter
increased significantly after glucose and cream intake, but TLR-4 expression and plasma LPS me
signal transdu
concentrations increased only after cream intake. The intake of orange juice or water did not work has show
induce any change in any of the indexes measured. Dia
in the circul
(MNCs) ofRu
2. the
CONCLUSIONS — Although both glucose and cream induce NF-␬B binding and an in- increased whe
crease in the expression of SOCS3, TNF-␣, and IL-1␤ in MNCs, only cream caused an increase normal subje
Wh
in LPS concentration and TLR-4 expression. Equicaloric amounts of orange juice or water did not work demonstsul
induce a change in any of these indexes. These changes are relevant to the pathogenesis of sion in MNCs
atherosclerosis and insulin resistance. deg
Figure 3—Change in NF␬B binding activity in MNC (A) and plasma endotoxin concentrations tyrosine phosp
Diabetes Care juice (OJ, ‚),
Ch
receptor and d
(B) in normal subjects after a 300-calorie drink of cream (E), glucose (Œ), orange 33:991–997, 2010
3. Sen
insulin resistan
and ؉, P Ͻ 0.05 with a great interest because the content of LPS
or water (F). Data are means Ϯ SEM. *ur recent work has shown thatRMANOVA comparing changes in sessment of in
TA
IR]), consiste
relation to baseline after cream and glucose challenges; # andin $, P meals 0.05 significantly differ-
high-fat high-cholesterol (HFHC) these Ͻ is not with two-way

33. LIGANDOS DOS TLRS

34. LPS • Citoquinas
• Enzimas
• Moléculas de adesão
TLR
IkB Cinase
P